Liver transplantation in fulminant hepatic failure: experience with 40 adult patients over a 17-year period.

Abstract

INTRODUCTION:

To evaluate the influence of pretransplantation recipient and donor prognostic factors on graft-patient survival.

MATERIALS AND METHODS:

Between April 1986 and June 2003, 40 liver transplantation (LT) procedures to treat fulminant hepatic failure were performed (5.7%). Twenty-one pre-LT recipient and donor variables were retrospectively considered for analysis.

RESULTS:

The indications for LT were hyperacute (62.5%), acute (35%), and subacute hepatic failure (2.5%). Glasgow Coma Scale scores ranged from <5 in 22 patients to > or =5 in 18 patients. The causes were hepatitis B (n = 21), unknown (n = 10), Amanita phalloides (n = 5), and other (n = 4). The 1-year graft and patient survival rates were 48.3% and 61.3%, respectively. Perioperative and late mortality was 27.5% and 22.5%. The only variable statistically significant for graft survival was waiting list time for LT <48 hours (P = .05).

DISCUSSION:

Liver transplantation is the best treatment for fulminant hepatic failure, with a 1-year patient survival rate of 61.3%. The short waiting list time has an important role in outcome.

• Authors: R Montalti, B Nardo, P Beltempo, R Bertelli, L Puviani, A Cavallari
• Journal: Transplantation proceedings (Transplant Proc) Vol. 37 Issue 2 Pg. 1085-7 (Mar 2005) ISSN: 0041-1345 [Print] United States
• PMID: 15848630 (Publication Type: Journal Article)

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Female
• Follow-Up Studies
• Glasgow Coma Scale
• Graft Survival
• Humans
• Liver Failure, Acute (surgery)
• Liver Transplantation (mortality, physiology)
• Male
• Middle Aged
• Retrospective Studies
• Survival Analysis
• Time Factors
• Treatment Outcome